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Apprentice comments on Humans are not automatically strategic - Less Wrong
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I predict with p=0.95 that you have at least one micronutrient deficiency which is greatly contributing to your depression, and that starting to take a multivitamin regularly would be enormously to your benefit. I predict with p=0.6 that you are specifically deficient in thiamine, and that a single dose of sulbutiamine (a molecule that crosses the blood-brain barrier and then breaks into two thiamine molecules) would cause a large and sudden reduction in your depression. I am basing this on my own experience with thiamine deficiency (caused by T1 diabetes), which produced in me a specific type of apathy which I recognize in your comments.
Unless you either lied about taking a multivitamin to your current doctor, or ignored their advice to take one, fire him or her and find a new one. Also, thoroughly research every drug you're currently taking. At a minimum, search for the name of each one on PubMed, skim the first few pages of titles and read some of the abstracts. Don't adjust anything without consulting a qualified doctor, but do make sure to have that consultation.
Following up on this may be the most important thing you ever do.
EDIT: One other thing - if you're on antidepressants, you should be getting blood work, of the "large checklist of tests" variety, done on a regular basis. Make sure your TSH has been tested at least once in the past two years (result will be interesting with p=0.1, but very interesting if it is).
I have been getting blood work; everything always comes out just fine. (Yes, thyroid hormone is one of the things that's been checked.) And none of the many doctors I've been dragged to have told me to take vitamins, although my psychiatrist has occasionally asked about my diet. There are multivitamins in my house, but I stopped taking them a long time ago because they're these really annoying, very large chewable tablets the size of quarters.
In terms of vitamin deficiency, I'm actually most suspicious of vitamin B12. Both my maternal grandmother and my mother have low levels and get B12 injections regularly. (My mom is currently 60.) I once asked my psychiatrist to have my B12 checked, but I don't think it actually has been.
Also, the basic effect of my antidepressants has been "Well, I am more cheerful now, but my life still sucks every bit as much as it did when I wasn't taking them." I'll quote a doctor's anecdote:
Perhaps the difference between me on antidepressants and me off antidepressants is that, while on antidepressants, I was willing to go do my homework even though I'd rather touch a hot stove than do another problem set, while when off them, no amount of social pressure from my parents and other authority figures could make me open up my textbook and get to work, because I just couldn't make myself do it no matter what happened.
Right now, I'm not necessarily depressed because I have screwed up brain chemicals. I'm depressed because I'm a 28-year-old lazy bum who doesn't think he'll ever be able to get a job he can stand and keep it for any length of time, is supported by (and lives with) his parents, doesn't have any close friends, has never been in a romantic relationship, lives in fear of having his parents decide to stop supporting him, is endlessly frustrated by his mother's (completely justified) demands that he help her with various tasks because she has MS and can barely walk, and doesn't have any particular goals in life other than "escape it".
I think I can't cope with being my mother's caretaker any more; I need to get an income and get the hell away from my parents, but I don't think I can do that, so I just stay where I am and put up with the same shit that's been making me miserable for the past eight or so years. (Before then, I was often miserable, but for different reasons.)
I apologize in advance for the long-shot other-optimizing but, well, here goes.
Something that has repeatedly worked for me to move from a lethargic, somewhat depressed state to an active and happy (if restless) state is to deliberately refrain from sexual release while not refraining from exposure to sexual stimuli. I came upon this independently but I've since found the same basic idea in Taoist literature and in femdom literature. It could also easily be pitched as an evo-psych idea.
Uh, what's the mechanism there?
I'm not aware of any research on this exact question so what literature there is is mostly religious or pseudo-scientific. What I do think is fairly well-established is that lack of sexual release makes men restless. Why 'restless' in my case translates to "active and happy" rather than, say, "aggressive and abusive" I don't exactly know. Some factors that may be relevant (but I had not thought of before now): a) My baseline personality is quite docile and submissive, b) Like many people here, I enjoy toying with self-hacking, c) I have lots of projects to pour extra energy into, projects that are satisfying intellectually and status-wise.
Presumably sublimation. At least, Freud's sublimation reminds me a heck of a lot of the Tantric Buddhism and Taoist ideas of collecting ch'i from sexual activities (or lack thereof) and using it for other purposes.